THE SCARS OF ABUSE: Healing comes slowly

Children who are abused in their earliest years face a long, uphill battle to recover from the mental and emotional wounds inflicted on them.

"There's trauma, and then there's trauma that happens when you're really little, which is harder to treat, because you don't have words to help you," said Dr. Velma Bacak, a child psychiatrist with Riverside Behavioral Health Center.

In addition to the trauma of abuse and malnutrition, neglected children may be deprived of attachment and socialization.

"That affects relationships all life long," Bacak said.

The Gloucester girl found naked and starving in a makeshift cage two weeks ago had so little interaction with people that her "basic development is likely to be stunted because speech, language, interpersonal skills come from interaction," said Richard Wilson, clinical manager of child and adolescent outpatient services with the Hampton-Newport News Community Services Board and a licensed professional counselor.

If she's nonverbal, "You'd be starting as if you're starting from infancy," Wilson said. "She would need intensive intervention to begin the process of helping her to acquire language."

Children pick up language naturally up to age 6 through interaction. "The older the child is, the tougher it is to do that, because those years have been lost," Wilson said.

Abused children also have a hard time learning to trust other people.

When the child-caregiver relationship is askew, it's hard for children to understand themselves and the world around them, said Dr. Bela Sood, medical director at the Virginia Treatment Center for Children and chair of the child psychiatry division at Virginia Commonwealth University Health System.

"It's difficult for them to believe that any adult could be trustworthy, that any adult could care about them or take care of them without engaging in that abusive, neglectful behavior," Sood said. "It's a process of learning that adults can be trusted again, and that what they experienced isn't going to be what they can expect from all adults."

Children who have been neglected emotionally may intentionally provoke negative responses from caregivers. "They're not accustomed to anybody appearing caring and supportive," Wilson said. "They're going to test that, if it's real, over and over and over."

Sometimes, children who were abused and/or neglected will exhibit symptoms of post-traumatic stress disorder, or PTSD, Wilson said. Or they may repeat elements of the abuse in playing with other children. .

"Play therapy" allows the child to show, in a nonverbal way, what they experienced. The intent is to resolve abusive scenarios, Wilson said. If a child's play has an adult figure repeatedly beating a child, he would point that's not how adults always treat children.

"Kids don't always see it as abuse, because it might be all they know, unfortunately," Wilson said. "But they know the pain."